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Individual

MR. WESLEY D WILKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA, OTR/L

Contact information

Practice address
827 SLACK ST, PEA RIDGE, AR 72751-3703
(479) 451-9434
(479) 488-6220
Mailing address
PO BOX 585, PEA RIDGE, AR 72751-0585
(479) 451-9434
(479) 488-6220

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA 2414
AR
225XP0019X
Physical Rehabilitation Occupational Therapist
OTR2768
AR

Other

Enumeration date
06/08/2010
Last updated
10/29/2014
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